THYROID-CARCINOMA PRESENTING AS AN ENLARGED CERVICAL LYMPH-NODE

Differentiated thyroid cancer most commonly presents as a thyroid nodu le. Cervical node metastases are commonly observed. In the present rep ort, we describe the clinical presentation, pathologic findings surgic al approach, and follow-up of 43 patients in whom the initial presenta tion of thyroid cancer was that of an enlarged cervical lymph node. At surgery, 65% of the patients had additional lymph node involvement. T he thyroid pathology was papillary carcinoma in all patients, and, in two thirds of patients, the thyroid primary was 1 cc or smaller in siz e. Forty patients underwent thyroidectomy and modified neck dissection ; 3 were treated by thyroidectomy alone. One patient died of disease, 7 were lost to follow-up after 4 to 27 years, 5 died of unrelated caus es, and the remaining 30 are alive and free of disease 1.5 to 33.5 yea rs after surgery (mean: 14.8 years).